| Organization Name: | GOUVERNEUR HOSPITAL, INC. |
| NPI Number: | 1295156412 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD T. LANG (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 77 W Barney St Gouverneur |
| State: | NY US |
| Postal Code: | 136421040 |
| Phone Number: | 3152871000 |
| Fax Number: | 3155359235 |
| NPI Enumeration Date: | 12/16/2013 |
| NPI Last Update Date: | 09/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |